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Cuts

Topic Overview

Causes of cuts

Cuts are open wounds through the skin. Normally the skin is under slight, constant tension as it covers the body. A cut is a forceful injury to the skin. Many people accidentally cut themselves with household or work items, yard tools, or when operating machinery. Children often are cut during play and sports activities, or from falls while riding wheeled toys, such as bikes, scooters, or skateboards. Most cuts are minor and home treatment is usually all that is needed.

Cuts can be caused by:

Blunt objects that tear or crush the skin (lacerations). These cuts are more common over bony areas, such as a finger, hand, knee, or foot, but they can occur anywhere on the body. Blunt object injuries usually cause more swelling and tissue damage and leave jagged edges, so problems with healing may occur.

A combination of blunt and sharp objects that tear, crush, and slice the skin tissue.

Types of cuts

Some types of cuts are more serious and need medical evaluation and treatment. These more serious cuts include:

Long or deep cuts.

Cuts that open with movement of the body area, such as a cut over a joint. A cut over a joint may take a long time to heal because of the movement of the wound edges.

Cuts that may scar and affect the appearance or function of a body area. A cut on an eyelid or lip which doesn't heal well may interfere with function or leave a noticeable scar.

Cuts that remove all of the layers of the skin (avulsion injuries), such as slicing off the tip of a finger. An avulsion injury may take a long time to heal.

Cuts from an animal or human bite. Infection is more likely with a bite injury.

Cuts that have damage to underlying tissues. Injuries to nerves, tendons, or joints are more common with cuts on the hands or feet. Slight swelling, bruising, and tenderness around a cut, bite, scrape, or puncture wound is normal. Swelling or bruising that begins within 30 minutes of the injury often means there is a large amount of bleeding or that damage to deeper tissues is present.

Cuts over a possible broken bone. Bacteria can get into a cut over a broken bone and infect the bone.

Cuts caused by a crushing injury. With this type of injury, the cut may have occurred when the skin split open from the force of the injury. The force of the injury may also damage underlying tissues and blood vessels. Crush injuries have a high risk of infection.

Cuts with a known or suspected object, such as glass or wood, in the wound.

Injury to the skin may also break small blood vessels under the skin and cause more swelling and bruising than you would expect.

Cuts to the head or face may appear worse than they are and bleed a lot because of the good blood supply to this area. Controlling the bleeding will allow you to determine the seriousness of the injury.

Remove large pieces of dirt or debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.

Hold the wound under cool running water. If you have a sprayer in your sink, you can use it to help remove dirt and other debris from the wound.

Scrub gently with water, a mild soap, and a washcloth.

If some dirt or other debris is still in the wound, clean it again.

If the wound starts to bleed, put direct, steady pressure on it.

If a chemical has caused a wound or burn, follow the instructions on the chemical's container or call Poison Control (1-800-222-1222) to find out what to do. Most chemicals should be rinsed off with lots of water, but with some chemicals, water may make the burn worse.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.

Long-term alcohol and drug problems.

Steroid medicines, which may be used to treat a variety of conditions.

Chemotherapy and radiation therapy for cancer.

Other medicines used to treat autoimmune disease.

Medicines taken after organ transplant.

Not having a spleen.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:

You haven't had a tetanus shot in the past 5 years.

You don't know when your last shot was.

For a clean wound, you may need a shot if:

You have not had a tetanus shot in the past 10 years.

You don't know when your last shot was.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.

Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.

Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Some types of facial wounds are more likely to leave a scar than others. These include:

Jagged wounds on the face.

Cuts on the eyelids.

Cuts to the lips, especially if they cut through the edge of the lip.

Stitches or other treatment may help prevent scarring. It's best to get treated within 8 hours of the injury.

With severe bleeding, any of these may be true:

Blood is pumping from the wound.

The bleeding does not stop or slow down with pressure.

Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

The bleeding slows or stops with pressure but starts again if you remove the pressure.

The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

The bleeding stops on its own or with pressure.

The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care in the next hour.

You do not need to call an ambulance unless:

You cannot travel safely either by driving yourself or by having someone else drive you.

You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Call 911 Now

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Puncture Wounds

Scrapes

Eye Injuries

Home Treatment

Minor cuts usually can be treated at home. If you do not have an increased chance of getting an infection, do not have other injuries, and do not need treatment by a doctor or a tetanus shot, you can clean and bandage a cut at home. Home treatment can help prevent infection and promote healing.

Treat bleeding

Nonprescription products are available to be applied to the skin to help stop mild bleeding of minor cuts, lacerations, or abrasions. Before you buy or use one, be sure to read the label carefully and follow the label's instructions when you apply the product.

After you have stopped the bleeding, check your symptoms to determine if and when you need to see your doctor.

Clean the wound

Clean the wound as soon as possible to reduce the chance of infection, scarring, and tattooing of the skin from dirt left in the wound.

Wash the wound for 5 minutes with large amounts of cool, clean water. Some nonprescription products are available for wound cleaning that numb the area so that cleaning doesn't hurt as much. Be sure to read the product label for correct use.

Don't use rubbing alcohol, hydrogen peroxide, iodine, or Mercurochrome, which can harm the tissue and slow healing.

Stitches, staples, or skin adhesives (also called liquid stitches)

Your doctor will tell you how to take care of your stitches or staples and when to return to have them removed. Skin adhesives usually do not need to be removed, but your doctor may wish to see you to check on the wound. Be sure to carefully follow your doctor's instructions. If you are unsure of how to care for your wound or have questions, call your doctor for instructions.

Consider applying a bandage

Most cuts heal well and may not need a bandage. You may need to protect the cut from dirt and irritation. Be sure to clean the cut thoroughly before bandaging it to reduce the risk of infection occurring under the bandage.

Select the bandage carefully. There are many products available. Liquid skin bandages and moisture-enhancing bandages are available with other first aid products. Before you buy or use one, be sure to read the label carefully, and follow the label's instructions when you apply the bandage.

If you use a cloth-like bandage, apply a clean bandage when it gets wet or soiled to further help prevent infection. If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove. If available, use a nonstick dressing. There are many bandage products available. Be sure to read the product label for correct use.

Watch for signs of infection. If you have an infection under a bandage, a visit to your doctor may be needed.

Apply a thin layer of petroleum jelly, such as Vaseline, lightly to the wound. It will keep the bandage from sticking to the wound.

Use an adhesive strip to hold the edges of a wound together. Always put an adhesive strip across a wound to hold the edges together, not lengthwise. You can make a butterfly bandage at home or purchase one to help hold the skin edges together.

Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

Carefully read and follow all directions on the medicine bottle and box.

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